Using existing and newly developed data, this study will investigate the longterm care status of Navajo elders age 60 years and older. The study builds on existing comprehensive multi-functional assessments data from a random sample of 1,040 community-resident Navajo elders that has been collected during pilot research. There are two stages, and multiple objectives, to the proposed research. In Stage 1, existing data will be analyzed to: 1) describe patterns of medical and social service use; 2) determine the correlates of use/non-use for specific services; and 3) identify elders in caregiving and dependent situations . To understand the factors influencing use, the Navajo Nation will conduct an inventory and evaluation of the medical and social service environment that will be matched with data obtained from elders. The service environment information is necessary so that lack of service availability and accessibility can be considered when analyzing and interpreting the patterns of service use. In Stage 2, additional data will be collected to address three issues critical to policy and planning: 1) identifying barriers (both structural and psychological) to the use of medical and social services; 2) describing the role of the primary caregiver in the decision to use and access support services; and 3) identifying the important characteristics leading to institutionalization of dependent elders. The additional information will be collected from the primary caregiver of the elder (whose identity is available in the pilot project data). Thus, the two data sets will be explicitly linked. Interviews with caregivers will also provide detailed information about the perceptions and attitudes toward caregiving, caregiver burden, and salient and problematic aspects of the caregiving situation. The general framework for the research issues and hypotheses that will be investigated are primarily derived from gerontological research on non-Indian populations. Many of these questions will address whether the American Indian elderly population is different from populations on which most gerontological research has been conducted. Where possible, hypotheses and research questions have "been derived from the American Indian aging research literature. Questions and hypotheses will answer whether the Navajo elderly are different from other American Indian elders.